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Published in: World Journal of Surgery 3/2006

01-03-2006

Training in Laparoscopic Appendectomy

Authors: Karl J. Sweeney, MD, Mary Dillon, MRCSI, Sean M. Johnston, MCH, Frank B. Keane, MD, Kevin C. Conlon, McH

Published in: World Journal of Surgery | Issue 3/2006

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Abstract

Background

The role of laparoscopic appendectomy (LA) in surgical training is unclear. Although LA as a therapeutic modality is potentially superior to open surgery, it has failed to become established as standard in training hospitals. The aim of the present study was to evaluate the outcome of LA performed by inexperienced surgeons in a training environment.

Materials and Methods

A retrospective analysis of all attempted LA performed over a 12-month period was undertaken. Data collected included operator grade (experienced and inexperienced), conversion rate and duration of surgery, complications, and postoperative stay.

Results

During the study period, 169 appendectomies were performed. The conversion rate to open surgery declined significantly from 28% in the first quarter to 9% in the last quarter, with no difference in the conversion rate between experienced and inexperienced surgeons. Operative time shortened significantly in the inexperienced group. Postoperative complications occurred in 8% of patients, independent of operative grade.

Conclusions

Our findings demonstrate that LA may be safely introduced as a teaching procedure. Time-to-train should not preclude institutions from adopting the laparoscopic approach in the treatment of acute appendicitis.
Literature
2.
go back to reference Frazee RC, Roberts JW, Symmonds RE, et al. A prospective randomised trial comparing open versus laparoscopic appendectomy. Ann Surg 1994;219:725–731PubMed Frazee RC, Roberts JW, Symmonds RE, et al. A prospective randomised trial comparing open versus laparoscopic appendectomy. Ann Surg 1994;219:725–731PubMed
3.
go back to reference Attwood SEA, Hill ADK, Murphy PG, et al. A prospective randomised trial comparing laparoscopic versus open appendectomy. Surgery 1992;112:497–501PubMed Attwood SEA, Hill ADK, Murphy PG, et al. A prospective randomised trial comparing laparoscopic versus open appendectomy. Surgery 1992;112:497–501PubMed
4.
go back to reference Hansen JB, Smithers BM, Schache D, et al. Laparoscopic versus open appendectomy: prospective randomised trial. World J Surg 1996;20:17–21CrossRefPubMed Hansen JB, Smithers BM, Schache D, et al. Laparoscopic versus open appendectomy: prospective randomised trial. World J Surg 1996;20:17–21CrossRefPubMed
5.
go back to reference Atabek U, Spence RK, Pello MJ, et al. Safety of teaching laparoscopic cholecystectomy to surgical residents. J Laparoendosc Surg 1993;3:23–26PubMed Atabek U, Spence RK, Pello MJ, et al. Safety of teaching laparoscopic cholecystectomy to surgical residents. J Laparoendosc Surg 1993;3:23–26PubMed
6.
go back to reference Duff SE, Dixon AR. Laparoscopic appendectomy: safe and useful for training. Ann R Coll Surg Engl 2000;82:388–391PubMed Duff SE, Dixon AR. Laparoscopic appendectomy: safe and useful for training. Ann R Coll Surg Engl 2000;82:388–391PubMed
7.
go back to reference Scott-Connor CEH, Hall TJ, Anglin BL, et al. Laparoscopic appendectomy. Initial experience in a teaching program. Ann Surg 1992;215:660–667 Scott-Connor CEH, Hall TJ, Anglin BL, et al. Laparoscopic appendectomy. Initial experience in a teaching program. Ann Surg 1992;215:660–667
9.
go back to reference Katkhouda N, Friedlander MH, Grant SW, et al. Intraabdominal abscess rate after laparoscopic appendectomy. Am J Surg 2000;180:456–461CrossRefPubMed Katkhouda N, Friedlander MH, Grant SW, et al. Intraabdominal abscess rate after laparoscopic appendectomy. Am J Surg 2000;180:456–461CrossRefPubMed
10.
go back to reference McCormick PH, Tanner WA, Keane FBV, et al. Minimally invasive techniques in common surgical procedures: implications for training. Irish J Med Sci 2003;172:27–29PubMed McCormick PH, Tanner WA, Keane FBV, et al. Minimally invasive techniques in common surgical procedures: implications for training. Irish J Med Sci 2003;172:27–29PubMed
11.
go back to reference Tate JJ, Chung SC, Dawson J, et al. Conventional versus laparoscopic surgery for acute appendicitis. Br J Surg 1993;80:761–764PubMed Tate JJ, Chung SC, Dawson J, et al. Conventional versus laparoscopic surgery for acute appendicitis. Br J Surg 1993;80:761–764PubMed
12.
go back to reference Nussbaum MS. Surgical endoscopy training is integral to general surgery residency and should be integrated into residency and fellowships abandoned. Semin Laparosc Surg 2002;9:212–215CrossRefPubMed Nussbaum MS. Surgical endoscopy training is integral to general surgery residency and should be integrated into residency and fellowships abandoned. Semin Laparosc Surg 2002;9:212–215CrossRefPubMed
13.
go back to reference M, Zacherl J, Rais A, Lipovac M, et al. Teaching laparoscopic cholecystectomy: do beginners adversely affect the outcome of the operation? Eur J Surg 2002;168:470–474PubMed M, Zacherl J, Rais A, Lipovac M, et al. Teaching laparoscopic cholecystectomy: do beginners adversely affect the outcome of the operation? Eur J Surg 2002;168:470–474PubMed
14.
go back to reference Carrasco-Prats M, Soria Aledo V, Lujan-Mompean JA, et al. Role of appendectomy in training for laparoscopic surgery. Surg Endosc 2003;17:111–114CrossRefPubMed Carrasco-Prats M, Soria Aledo V, Lujan-Mompean JA, et al. Role of appendectomy in training for laparoscopic surgery. Surg Endosc 2003;17:111–114CrossRefPubMed
15.
go back to reference Elder S, Kunin J, Chouri H, et al. Safety of laparoscopic cholecystectomy on a teaching service. Surg Laparosc Endosc 1996;6:218–220PubMed Elder S, Kunin J, Chouri H, et al. Safety of laparoscopic cholecystectomy on a teaching service. Surg Laparosc Endosc 1996;6:218–220PubMed
16.
go back to reference Francis NK, Hanna GB, Cuschieri A. The performance of master surgeons on the Advanced Dundee Endoscopic Psychomotor Tester: contrast validity study. Arch Surg 2002;137:841–844PubMed Francis NK, Hanna GB, Cuschieri A. The performance of master surgeons on the Advanced Dundee Endoscopic Psychomotor Tester: contrast validity study. Arch Surg 2002;137:841–844PubMed
17.
go back to reference Rosen J, Solazzo M, Hannaford B, et al. Objective laparoscopic skills assessments of surgical residents using Hidden Markov Models based on haptic information and tool/tissue interactions. Stud Health Technol Inform 2001;81:417–423PubMed Rosen J, Solazzo M, Hannaford B, et al. Objective laparoscopic skills assessments of surgical residents using Hidden Markov Models based on haptic information and tool/tissue interactions. Stud Health Technol Inform 2001;81:417–423PubMed
18.
go back to reference Gallagher HJ, Allen JD, Tolley DA. Spatial awareness in urologists: are they different? Br J Urol Int 2001;88:666–670 Gallagher HJ, Allen JD, Tolley DA. Spatial awareness in urologists: are they different? Br J Urol Int 2001;88:666–670
19.
go back to reference Luckmann R, Davis P. The epidemiology of acute appendicitis in California: race, gender, and seasonal variation. Epidemiology 1991;2:323–330PubMed Luckmann R, Davis P. The epidemiology of acute appendicitis in California: race, gender, and seasonal variation. Epidemiology 1991;2:323–330PubMed
20.
go back to reference Addiss DG, Shaffer N, Fowler BS, et al. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol 1990;132:910–925PubMed Addiss DG, Shaffer N, Fowler BS, et al. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol 1990;132:910–925PubMed
22.
go back to reference Chung RS, Rowland DY, Li P, et al. A meta-analysis of randomised controlled trials of laparoscopic versus conventional appendectomies. Am J Surg 1999;177:250–256PubMed Chung RS, Rowland DY, Li P, et al. A meta-analysis of randomised controlled trials of laparoscopic versus conventional appendectomies. Am J Surg 1999;177:250–256PubMed
23.
go back to reference Garbutt JM, Soper NJ, Shannon WD, et al. Meta-analysis of randomised controlled trials comparing laparoscopic and open appendectomy. Surg Laparosc Endosc 1999;9:17–26CrossRefPubMed Garbutt JM, Soper NJ, Shannon WD, et al. Meta-analysis of randomised controlled trials comparing laparoscopic and open appendectomy. Surg Laparosc Endosc 1999;9:17–26CrossRefPubMed
24.
go back to reference Fritts LL, Orlando R. Laparoscopic appendectomy: a safety and cost analysis. Arch Surg 1993;128:521–525PubMed Fritts LL, Orlando R. Laparoscopic appendectomy: a safety and cost analysis. Arch Surg 1993;128:521–525PubMed
25.
go back to reference Meinke AK, Kossuth T. What is the learning curve for laparoscopic appendectomy? Surg Endosc 1994;8:371–375CrossRefPubMed Meinke AK, Kossuth T. What is the learning curve for laparoscopic appendectomy? Surg Endosc 1994;8:371–375CrossRefPubMed
26.
go back to reference Navez B, Penninckx F. Laparoscopic training: results of a Belgian survey in trainees. Belgian Group for Endoscopic Surgery (BGES). Acta Chir Belg 1999;99:53–58PubMed Navez B, Penninckx F. Laparoscopic training: results of a Belgian survey in trainees. Belgian Group for Endoscopic Surgery (BGES). Acta Chir Belg 1999;99:53–58PubMed
Metadata
Title
Training in Laparoscopic Appendectomy
Authors
Karl J. Sweeney, MD
Mary Dillon, MRCSI
Sean M. Johnston, MCH
Frank B. Keane, MD
Kevin C. Conlon, McH
Publication date
01-03-2006
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 3/2006
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-005-0311-7

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